经鼻蝶泌乳素型垂体腺瘤手术治疗的临床疗效分析

目的探讨经单侧鼻孔蝶窦入路手术切除泌乳素(PRL)型垂体腺瘤的疗效。方法回顾性分析2009年1月至今收治20例泌乳素腺瘤患者的临床及影像资料,根据术前血PRL水平分成3组进行手术疗效对比分析,分别为:<100ng/mL、100ng/mL～200ng/mL及>200ng/mL。结果本组患者无死亡病例,术中术后未见出血、无脑脊液鼻漏、无发热、无视力下降等并发症。肿瘤全切除率95.0%(19/20),次全切除率5.0%(1/20)。术前是否服用溴隐亭的患者手术疗效无明显影响。术后20例患者中12例PRL水平恢复至正常水平。3组患者术后PRL恢复正常率分别为100%、83.3%、12.5%。结论经单鼻孔蝶窦入路手术是治疗泌乳素腺体瘤的有效手段,其中术前PRL水平是影响手术疗效和预后的主要因素,而术前是否服用溴隐亭对手术疗效未见有明显影响。

Analysis of Clinical Efficacy of Single-nostril Transsphenoidal Approach for Prolactinoma

Objective To study the therapeutic effects of endonasal trans-sphenoidal microsurgery on prolactinoma. Method CIinical data of 20 patients with prolaetinoma were retrospectivly analyzed from Jan. of 2009 up to now, The patients were divided into three groups according to prolactin level （PRL）. Results PRL in 12 of 20 eases was recovered. The recovering rates of PRL after operation were 100%. 83.3%. 12,5% respectively. The therapeutic effect was not significantly different between patients with and without preoperative treatment by bromocriptine. Conclusion Endonasal transsphenoidal m ierosurgery is one of the effective treatments of prolactinoma, Preoperative prolactin level is the main t＇actor that may affect the therapeutic effect of surgery. Preoperative application of bromocriptine has no influence on prognosis.